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在新诊断的急性淋巴细胞白血病的成年人中,TP53突变及其变异性等位基因频率的影响

Roberta S Azevedo¹, Elias Jabbour², Hagop M Kantarjian¹

¹The University of Texas MD Anderson Cancer Center, Houston, Texas, United States.

|December 3, 2025

概括

TP53突变影响急性淋巴细胞白血病 (ALL) 的存活率,特别是在老年人中. TP53突变的高变异基频率 (VAF) 与老年患者复发风险增加有关,但与年轻患者无关.

科学领域:

血液学血液学血液学
在瘤学瘤学.
遗传学遗传学是一个

背景情况:

TP53突变与血液癌症的不良结果有关.
在急性淋巴细胞白血病 (ALL) 中TP53突变和变异性等位基频率 (VAF) 的作用需要进一步澄清.

研究的目的:

调查TP53突变及其VAF在新诊断的ALL的预后影响.
为了确定TP53VAF是否影响不同年龄组和治疗环境中的结果.

主要方法:

在新诊断的ALL患者中对TP53突变和VAF的回顾性分析.
评估无事件生存 (EFS),总生存 (OS),复发累积发病率 (CIR) 和TP53在缓解后的持续性.

主要成果:

TP53突变发生在17.2%的ALL患者中,更频繁地发生在老年人和患有Ph-负B细胞ALL的人中.
在60岁以上的患有Ph阴性B细胞ALL的患者中,TP53VAF与4年EFS和OS (28%) 差异相关,因为复发风险增加.
在60岁以下的患者中,TP53VAF没有影响EFS或OS,但较高的VAF (≥45%) 与4年CIR (35%) 的增加有关.
在44%的患者中观察到缓解后的TP53持久性,并且与更高的ALL复发风险有关.

结论:

TP53VAF是老年患者 (≥60岁) 具有Ph-负B细胞ALL的显著预后因素,主要是通过增加复发风险.
TP53突变状态和VAF不能独立预测年轻ALL患者 (<60岁) 的结果.
治疗后TP53持续性与ALL复发的风险增加有关.

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